Introduction Within the eSTI² consortium, we conducted exploratory studies of an innovative Online Chlamydia Pathway (OCP: results service, automated clinical consultation, electronic prescription via community pharmacy, online partner management, with telephone helpline support). Access to traditional services was facilitated where appropriate.

Objectives To describe patients’ use and perceptions of the OCP.

Methods In-depth qualitative interviews with 40 purposively-sampled OCP users (21/40 female, aged 18–35) analysed thematically.

Results Interviewees chose the OCP to obtain treatment rapidly, conveniently and inconspicuously, within busy lifestyles that impeded clinic access. They described completing the online consultation promptly and discreetly, often using smartphones. Many found the online information provided comprehensive, but those who completed the consultation in public locations and proceeded immediately to the pharmacy, described lacking information (which they apparently overlooked). Treatment collection from pharmacies was acceptable, but sometimes pharmacy staff lacked knowledge of the OCP (despite training), causing delays and conversations which threatened patients’ privacy – undermining the OCP’s perceived benefits. For those routed to clinic (as opposed to choosing to attend), the OCP’s anticipated benefits were also compromised. They described annoyance, anxiety, and did not always understand why a clinic visit was needed. The helpline was valued; users found it reassuring and informative.

Conclusion The OCP is a promising adjunct to traditional care, particularly when integrated into sexual health services. Critical points in users’ journeys include the interface with pharmacies and clinics. Implementation issues in pharmacies need addressing. Management of users’ expectations and tailored information may improve the experience when routed to clinic.